Welfare Reform on the Web - January 2001: National Health Service - funding

ALZHEIMER'S PATIENTS LEFT TO PAY FOR DRUGS

J. Laurance

Independent, Oct. 12th 2000, p.10

A national survey has found that 48% of health authorities funded a group three expensive drugs that can slow down or reverse symptoms of Alzheimer's disease in about half of all patients. Of the authorities that do fund the drugs, 60% restricted their use. In most authorities where there was no formal funding, GPs or hospital trusts supplied some patients out of their own budgets. In one in six authorities there was no NHS access to the drugs. The cost effectiveness of the drugs is being assessed by the National Institute for Clinical Excellence, but there are concerns that, even if NICE rules in favour of the drugs, health authorities may still refuse to fund them.

HEALTH TAX BREAKS UNLIKELY TO CURE THE NHS

L. Paterson

Times, Oct. 11th 2000, p.31

Argues that tax relief on private health insurance would only benefit the well-off who already have cover. Most people with private cover regard it as a top-up, not a substitute for state provision and still rely on the NHS for GP visits and emergency care, so increased private insurance would not lead to reduced demand on the NHS. Tax breaks would also diminish support for increases in NHS spending and could also sap scarce NHS staff resources as medical personnel move into the private sector.

MARKET TESTING ENDS FOR NHS

S. Ward

Public Finance, Oct. 6th-12th 2000, p.15

Reports that the compulsory market testing of support services such as cleaning and catering is to be replaced by a version of Best Value, called Value for Patients. Hospitals will have to review their support services every five years to demonstrate that they are meeting quality standards and getting value for money. If not, then services should be market tested, but with a new emphasis on satisfaction and quality as well as cost.

PFI IS BAD FOR YOUR HEALTH

A. Pollock

Public Finance, Oct. 6th-12th 2000, p.30-31

Argues that the affordability gap which occurs under PFI has led to fewer NHS beds and clinical services. The PFI is more expensive than conventional procurement, offers poor value for money and will result in lower levels of NHS service provision.

PRIVATE FINANCE AND SERVICE DEVELOPMENT

S. Boyle and A. Harrison

Health Care UK, Autumn 2000, p.55-63

New hospitals are being built through the private finance initiative without regard to how they fit in with other health services. They could leave the NHS with expensive buildings which become outdated within a few years, but for which it still has to pay. Proposes that all new hospitals should be commissioned regionally, with design competitions to bring in ideas about how hospitals could respond better to patients' needs.

PRIVATE FINANCE, PUBLIC HEADACHE: THE PFI FUTURE

S. Boyle and A. Harrison

British Journal of Health Care Management, vol.6, 2000, p.489-491

Problems with the private financing of hospital building include:

• lack of whole systems planning;
• failure to deliver sufficient capacity to meet the needs of the local population;
• failure to deliver innovative designs;
• failure to demonstrate that the schemes will deliver better value for money.

WHY LABOUR FEARS AN NHS UNDERSPEND

S. Brown

Public Finance, Oct. 13th-19th 2000, p.12

New NHS funding is highly targeted and has been allocated late in the financial year. There is a serious danger of underspending while also missing targets, such as cutting inpatient waiting lists. This could seriously embarrass the government.